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Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program
OBJECTIVE: Tofacitinib is an oral JAK inhibitor indicated for the treatment of rheumatoid arthritis (RA). We characterized lymphoma events in the tofacitinib RA clinical development program. METHODS: Lymphoma events (up to March 2015) were identified from 19 tofacitinib studies (2 phase I, 9 phase I...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947561/ https://www.ncbi.nlm.nih.gov/pubmed/28941219 http://dx.doi.org/10.1002/acr.23421 |
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author | Mariette, Xavier Chen, Connie Biswas, Pinaki Kwok, Kenneth Boy, Mary G. |
author_facet | Mariette, Xavier Chen, Connie Biswas, Pinaki Kwok, Kenneth Boy, Mary G. |
author_sort | Mariette, Xavier |
collection | PubMed |
description | OBJECTIVE: Tofacitinib is an oral JAK inhibitor indicated for the treatment of rheumatoid arthritis (RA). We characterized lymphoma events in the tofacitinib RA clinical development program. METHODS: Lymphoma events (up to March 2015) were identified from 19 tofacitinib studies (2 phase I, 9 phase II, 6 phase III, and 2 long‐term extension) of patients with moderate to severe RA. Patients in these studies received tofacitinib dosed at 1–30 mg twice daily or 20 mg once daily, as monotherapy or with conventional synthetic disease‐modifying antirheumatic drugs. Lymphoma incidence rates (IRs; number of patients with events/100 patient‐years) and standardized incidence ratios (SIRs) were calculated. A descriptive case–matched control analysis (1:4) was performed to identify potential risk factors for lymphoma. RESULTS: A total of 6,194 patients received tofacitinib (19,406 patient‐years of exposure, 3.4 years median treatment duration). Nineteen lymphomas occurred (IR 0.10 [95% confidence interval (95% CI) 0.06–0.15]), with no increase observed with time of exposure. The age‐ and sex‐adjusted SIR of lymphoma was 2.62 (95% CI 1.58–4.09) (Surveillance, Epidemiology, and End Results [SEER] program database). The clinical characteristics of the 19 lymphomas were typical for the RA population. Three lymphomas were positive for Epstein‐Barr virus, 8 were negative, 2 were equivocal, and 6 were untested. Numerically, more lymphoma cases had a history of Sjögren's syndrome and were positive for anti–cyclic citrullinated protein and rheumatoid factor at baseline versus matched controls. The mean corticosteroid dose was higher for lymphoma cases versus controls. CONCLUSION: In the tofacitinib RA clinical development program, lymphoma rates were stable over time and there were minimal differences in the baseline characteristics of patients with and without lymphoma. |
format | Online Article Text |
id | pubmed-5947561 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-59475612018-05-17 Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program Mariette, Xavier Chen, Connie Biswas, Pinaki Kwok, Kenneth Boy, Mary G. Arthritis Care Res (Hoboken) Rheumatoid Arthritis OBJECTIVE: Tofacitinib is an oral JAK inhibitor indicated for the treatment of rheumatoid arthritis (RA). We characterized lymphoma events in the tofacitinib RA clinical development program. METHODS: Lymphoma events (up to March 2015) were identified from 19 tofacitinib studies (2 phase I, 9 phase II, 6 phase III, and 2 long‐term extension) of patients with moderate to severe RA. Patients in these studies received tofacitinib dosed at 1–30 mg twice daily or 20 mg once daily, as monotherapy or with conventional synthetic disease‐modifying antirheumatic drugs. Lymphoma incidence rates (IRs; number of patients with events/100 patient‐years) and standardized incidence ratios (SIRs) were calculated. A descriptive case–matched control analysis (1:4) was performed to identify potential risk factors for lymphoma. RESULTS: A total of 6,194 patients received tofacitinib (19,406 patient‐years of exposure, 3.4 years median treatment duration). Nineteen lymphomas occurred (IR 0.10 [95% confidence interval (95% CI) 0.06–0.15]), with no increase observed with time of exposure. The age‐ and sex‐adjusted SIR of lymphoma was 2.62 (95% CI 1.58–4.09) (Surveillance, Epidemiology, and End Results [SEER] program database). The clinical characteristics of the 19 lymphomas were typical for the RA population. Three lymphomas were positive for Epstein‐Barr virus, 8 were negative, 2 were equivocal, and 6 were untested. Numerically, more lymphoma cases had a history of Sjögren's syndrome and were positive for anti–cyclic citrullinated protein and rheumatoid factor at baseline versus matched controls. The mean corticosteroid dose was higher for lymphoma cases versus controls. CONCLUSION: In the tofacitinib RA clinical development program, lymphoma rates were stable over time and there were minimal differences in the baseline characteristics of patients with and without lymphoma. John Wiley and Sons Inc. 2018-04-02 2018-05 /pmc/articles/PMC5947561/ /pubmed/28941219 http://dx.doi.org/10.1002/acr.23421 Text en © 2017 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Rheumatoid Arthritis Mariette, Xavier Chen, Connie Biswas, Pinaki Kwok, Kenneth Boy, Mary G. Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title | Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title_full | Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title_fullStr | Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title_full_unstemmed | Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title_short | Lymphoma in the Tofacitinib Rheumatoid Arthritis Clinical Development Program |
title_sort | lymphoma in the tofacitinib rheumatoid arthritis clinical development program |
topic | Rheumatoid Arthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947561/ https://www.ncbi.nlm.nih.gov/pubmed/28941219 http://dx.doi.org/10.1002/acr.23421 |
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